Meaningful use in healthcare information systems

¶ … Patient Electronic Access

The objective of this study is to investigate the application of the electronic health record at the inner City health hospital. The goal of implementing the program is to allow patients to have easy access to their health data and information to assist them sharing their health information with other healthcare and personal care providers. This study investigates the application of Measure 1 Stage 1 for the City Health organization. Following the benefits of the electronic health records, the City Health has decided to implement the new program. The program will allow patients to access their information on demand through PHR (personal health record). However, the City Hospital will be able to derive benefits from the program by setting aside $170,000 for the implementation costs and $90,500 maintenance expenses. Moreover, the City Hospital should organize a training program for the staff to make the program be successful.

Introduction

"The Patient Electronic Access provides patients the ability to view online, download, and transmit their health information within 4 business days of the information being available to the EP." (CMS, 2016 p 1).

The Medicaid and Medicare introduce the electronic health record incentive programs to encourage patients' involvement in their healthcare systems. In other words, accessibility of patient health information online allows patients to make an informed decision regarding their healthcare and provide critical information to their personal caregivers and care providers. The objective of the EP is to allow a physician views health information online, downloading the information and transmitting the health information within four business days to patients. The City Health hospital has been using the manual method to record patient's health data for several decades. The method is not only time-consuming, the manual method is also not cost-effective because a large amount of time is wasted before recording and accessing patient's information. Moreover, the hospital does not have the policy to allow patients accessing their health information. Nevertheless, the City Hospital is under the Medicaid and Medicare program, and the hospital realizes more than 70% of their revenue from the Medicaid and Medicare government program. Since, the government has mandated all hospitals under the Medicaid and Medicare programs to implement the electronic health record incentive programs, the management of the City hospital has made a decision to implement the program. The objective of this project is to investigate the application of the Meaningful Use electronic health record Measure I, Stage 1 at the inner City health hospital.

Analysis

The Meaningful Use is the federal government incentive program, which encourages healthcare providers to use and adopt an (electronic health record) to improve patients' quality of care. The goals of Meaningful Use are to:

• Improve safety, quality, and efficiency of care

• Engage family and patients in the healthcare delivery

• Improve care coordination

• Improve public health and population

• Maintain security and privacy of patients' health information.

The Recovery Act that establishes the Meaning Use certifies the application of e-prescribing, and uses certified EHR technology to enhance clinical quality care. Basic features of the Meaningful Use Stage 1 are to achieve the clinical and objective quality measures. A hospital that intends to apply the Measure 1 of the patient electronic access must have 80% of their patients having their records stored in the certified EHR technology. In the Stage 1 of the Measure 1, the eligible professionals are to complete 15 core objectives where 5 out of 10 are from the menu set. Moreover, hospital intending to implement Stage 1 must complete 14 core objectives and 15 CCM (clinical quality measures).

The hospitals adopting the Medicaid and Medicare are to implement an effective EHR to receive payments from the federal government. Since it is mandatory for the City Hospital to adopt the Meaningful Use, the hospital should implement Measure 1, Stage 1 to enhance the quality of healthcare delivery. While many patients have their primary care physicians, however, many of them are not affiliated with the hospitals. Thus, the goal of the plan is to transmit the patient data electronically and providing access for patients. The Measure 1 of the patient electronic access is designed to provide a timely access to the electronic health records for patients. Moreover, the Measure 1 allows patients to have a timely access to their health information online as well as downloading the information, and transmitting the information to the third party subject to the EP discretion. The EP Measure 1 also has an exclusion that states that the participating hospital should neither create or order information listed in the EP inclusion except for provider's name, patient' name and provider office contact information. However, the provision of Measure 1 prohibits the health care providers from having access to the email addresses of patients. Although, some CEHRT (certified EHR technology) products can be designed in this fashion, however, if CEHRT requires patients' emails, and they elect to opt participation or refuse to provide their emails, the provider is not allowed to exclude the patient from the program. (Hillestead, Bigelow, Bower, 2005).

The benefit of Measure 1 to the City Hospital is that it will assist a patient in accessing their health information in a timely manner and evaluating the health received by their providers. Moreover, the Measure 1 will allow the application of the clinical decision support to enhance the quality of care through the electronic reporting system, which assists in providing high priority to quality of healthcare. Moreover, the Measure 1 will assist the hospital to speed up the medication orders as well as enhancing the medication records through the computerized order entry. (Hillestad, James, Katya, et al. 2005). Measure 1 will also allow an access to patient information in the different form, however, Measure 1 does not allow the provider to obtain the patient email address. Through Measure 1, patients will have the right to have access to their health information through their authorized representatives. However, the timeline that requires making health information available is 36 hours for the authorized hospital. However, the timeline to make the EP (Eligible Professionals) information available for the patient is four business days, and the provider does not require enrolling patients the second time if already having their information stored in the electronic health record. Specifically, it is revealed that 50% of all patients consulted by the professionals must provide a timely online access subject to the professional's discretion to hold some specific information. (ASCRS, 2015).

Despite the benefits that the hospital will enjoy with the application of the patient electronic access, the City Health will still face challenges in the implementation plan. First, the implementation will require high costs. For example, the hospital will need to approve enough fund to purchase the hardware and software for the new information systems. Additionally, the organization will need to hire competent IT expert to manage the systems. According to the Department of Labor (2015), the annual salary of a competent computer professional is between $70,000 and $110,000. Moreover, some patients may lack the technical knowledge to operate the computer systems.

Despite the identified challenges, the benefits that the City hospital will derive from the implementation of the patient's electronic access are more than the shortcomings. The patient's electronic access will assist patients to access their health information in a timely manner. Moreover, patient electronic access will assist physicians and nurses to access patient records quickly thereby making a timely decision about patient health. The new program will also help the City Health to reduce the cost of operations because the staff will perform the same works with fewer resources, which will enhance the quality of healthcare delivery. (Shukla, 2000).

Additionally, the City Health will record a significant costs reduction in transcription services and a reduction in pulling paper charts. The system will create a template to search the patient records electronically without wasting much time. Stage 1 of the systems will assist the organization to make an effective clinical decision support. The hospital will also have access to the following patient electronic access:

Stage 1: CPOE (Computerized Provider Order Entry)

Stage 1 Patient Electronic Access

Stage 1 - Protect Patients' Health Information

Stage 1 Secure Messaging

Stage 1 Public Health Reporting

Implementation Plan

The new system will provide the quality of care and assist the hospital in recording annual cost savings. The time to implement the new system will be 14 weeks and the implementation plan is as follows:

Formation of Implementation Team: The implementation team will consist of Project manager, physicians, nurses, IT manager, receptionists, medical assistants, and administrative staff. The formation of implementation will be seven days.

Configure the software and Hardware: The City Hospital will also require the software for the project that will include Practice management software, EHR software, and computerized order entry. The hardware will consist of Server, laptop, desktop, network, and printer.